Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug:73:75-81.
doi: 10.1016/j.euroneuro.2023.04.005. Epub 2023 May 4.

Factors associated with lamotrigine concentration/dose ratio in individuals with bipolar disorders

Margot Chouchana  1 , Clément Delage  2 , Ophélia Godin  3 , Jean-Eudes Fontan  4 , Frank Bellivier  5 , Sebastien Gard  6 , Valérie Aubin  7 , Raoul Belzeaux  8 , Caroline Dubertret  9 , Emmanuel Haffen  10 , Marion Leboyer  11 , Emilie Olie  12 , Philippe Courtet  12 , Mircea Polosan  13 , Paul Roux  14 , Ludovic Samalin  15 , Raymund Schwan  16 , Antoine Lefrere  17 , Vanessa Bloch  2 , Bruno Etain  5 ; FondaMental Advanced Center of Expertise for Bipolar Disorders (FACE-BD)
Collaborators, Affiliations

Factors associated with lamotrigine concentration/dose ratio in individuals with bipolar disorders

Margot Chouchana et al. Eur Neuropsychopharmacol. 2023 Aug.

Abstract

Monitoring of lamotrigine levels is recommended in epilepsy. However, in bipolar disorders (BD), no study has described the therapeutic range in daily practice and factors being associated to it. We used retrospective data of individuals with BD, treated with lamotrigine, and included in the FondaMental Advanced Centers of Expertise for Bipolar Disorders cohort. We extracted clinical and biological data and explored associations between these variables and lamotrigine concentration/dose (C/D) ratio. The database included 675 individuals who received lamotrigine at inclusion, whose main characteristics were female sex (68.3%) and BD type 2 (52.1%). Data about lamotrigine C/D ratio were available for 205 individuals. Lamotrigine C/D ratio was significantly associated with: Body Mass Index (BMI) (r=-0.159), estimated GFR (glomerular filtration rate) (r=-0.228), total bilirubin (r = 0.241) and at a trend level, antidepressant co-prescription (U = 3169). The model obtained was: lamotrigine C/D ratio = 1.736 - 0.013*BMI + 0.095*total bilirubin (UI/L) - 0.007*eGFR (ml/min) + 0.210*AST/ALT - 0.004*GGT (UI/L) + 0.014*age (year) + 0.303*currently smoking (yes or no) - 0.588*antidepressant co-prescription (yes or no) - 0.357*gender (F = 1.899, p = 0.057, adjusted R2 = 0.11) Information about plasma lamotrigine C/D ratio were available for only 205 out of the 675 individuals in the database and has been obtained from different laboratories. The representativeness of the included sample may be questionable. This is the first study providing information on a large sample of individuals with BD regarding factors associated with lamotrigine C/D ratio. This study allows to propose a model of lamotrigine C/D ratio that would deserve further replication.

Keywords: Bipolar disorder; Concentration/dose ratio; Lamotrigine; Plasma level.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest Ludovic Samalin has received CME-related honoraria and served as consultant for Janssen- Cilag, Lundbeck, Otsuka, Sanofi-Aventis with no financial or other relationship relevant to the subject of this article. Bruno Etain has served as consultant for Sanofi-Aventis with no financial or other relationship relevant to the subject of this article. Raoul Belzeaux received CME- related honoraria and served as consultant for Janssen-Cilag, Lundbeck, Sanofi-Aventis with no financial or other relationship relevant to the subject of this article. The other authors declared no conflict of interest in relation to this article.

References

Publication types